Health care leaders' perspectives on the business impact of mobile health clinics.

BACKGROUND: By analyzing how health care leaders in the United States view mobile health programs and their impact on the organization's bottom line, this study equips those who currently operate or plan to deploy mobile clinics with a business case framework. Our aim is to understand health care leaders' perspectives about business-related incentives and disincentives for mobile healthcare. METHODS: We conducted 25 semi-structured key informant interviews with U.S. health care leaders to explore their views and experiences related to mobile health care. We used deductive and inductive thematic analysis to identify patterns in the data. An advisory group with expertise in mobile health, health management, and health care finance informed data collection and analysis. RESULTS: In addition to improving health outcomes, mobile clinics can bolster business objectives of health care organizations including those related to budget, business strategy, organizational culture, and health equity. We created a conceptual framework that demonstrates how these factors, supported by community engagement and data, come together to form a business case for mobile health care. DISCUSSION: Our study demonstrates that mobile clinics can contribute to health care organizations' business goals by aligning with broader organizational strategies. The conceptual model provides a guide for aligning mobile clinics' work with business priorities of organizations and funders. CONCLUSIONS: By understanding how health care leaders reconcile the business pressures they face with opportunities to advance health equity using mobile clinics, we can better support the strategic and sustainable expansion of the mobile health sector.

Humanitarian reason and the movement for overdose prevention sites: The NGOization of the Opioid "Crisis".

In August 2017, a group of activists erected in Ottawa's downtown a tent as a first overdose prevention site as a response to what the public and the activists perceived as an epidemic-a devastating wave of opioid and fentanyl overdoses in Canada. The Ontario premier was urged to declare an emergency that would provide increased funding for harm reduction and also send a message to survivors and families that the lives of their loved ones mattered. Thus, the discourses around the so-called opioid crisis used a language of moral sentiments to legitimate political action. This "new humanitarianism" is considered a priori as good, but in this article, I ask what is politically at stake if we base our actions on the logic of humanitarian reason. The new universalism of humanitarian organizations is based on the individualism of human rights and thus on a moral imperative that replaces the political. Initiatives like the OPS movement often fill the gaps in social services in the absence of the state and address social problems as emergencies and public health issues, thereby transforming them into medical problems-performing the medicalization of sociopolitical problems. This is what I call the NGOization of the opioid crisis. This form of humanitarianism is a universalism of the temporal present without any universal promise for a better future or the amelioration of human conditions-it is a humanitarianism of emergency. What characterizes new humanitarianism is that it responds to situations of suffering that are the result of increasing inequality and injustices without addressing the root causes of this suffering. Not addressing these causes means to be complicit in perpetuating the inequalities and to restrict visions of possible alternatives.

Participation in collaborative projects as a precursor of trust in organizations for individuals with intellectual disability.

The present study focuses on organizations delivering services to individuals with intellectual disability, where trust relations between professionals and family members are required. More specifically, we examine the existence of significant differences in the degree to which family members and professionals trust each other. We also propose that their joint participation in collaborative teams (VI) will improve trust (VD). Specifically, our teams (experimental condition) designed and implemented collaborative projects with the participation of professionals and family members. Participants in the control condition did not participate in the collaborative projects. Our results confirmed that family members trust professionals more than professionals trust family members. Their joint participation in collaborative projects improved professionals' trust in family members over time, compared to the control condition. The effect of collaborative projects was not significant for family members' trust in professionals.

Labor Clinics in pandemic times / Clínicas do Trabalho em tempos de pandemia / Clínicas de trabajo en tiempos de pandemia

The present article addresses the effects of the pandemic on the labor world, based on the Clinical Labor field's perspective. Some of the new issues about changes in processes such as work organization, work experience and ethical-political-aesthetic implications in these processes were herein mapped. Ethical-political-aesthetic implications are herein understood as the ways actions focused on male and female workers are taken, on collectivization and/or individualization processes to be put in place, not to mention the statute ruling the ways of life yet be created. It also analyzes what Labor Clinic can do during the pandemic, as well as the modulations necessary in the clinical labor field to deal with the new urgencies of our time. It emphasizes the importance of following the normativity experienced in and through labor as an activity in times of intense transformations in labor processes due to the Covid-19 health crisis.

O artigo aborda os efeitos da pandemia no mundo do trabalho na perspectiva do campo Clínico do Trabalho. Mapeiam-se algumas das novas questões que se apresentam em termos de mudança nos modos de organização do trabalho, experiência do labor e implicações ético-político-estéticas nesse processo. Por estas últimas, entendem-se os modos como o agir no mundo entre trabalhadoras e trabalhadores vai se desenhar, os processos de coletivização e/ou individualização que serão produzidos, bem como o estatuto dos modos de vida que serão criados. Analisa-se, ainda, o que pode a Clínica do Trabalho na pandemia, bem como quais são as modulações necessárias no campo clínico do trabalho tendo em vista as novas urgências de nosso tempo. Exaltamos a importância de acompanhar a normatividade experimentada no e pelo trabalho como atividade nesse momento de intensas transformações dos processos de trabalho em razão da crise sanitária da Covid-19.

El artículo aborda los efectos de la pandemia en el mundo del trabajo desde la perspectiva del campo del trabajo clínico. Se mapean algunas de las nuevas preguntas que se plantean en términos de cambio en las formas de organización del trabajo, experiencia laboral e implicaciones ético-político-estéticas en este proceso. Por este último entendemos las formas en que se diseñará la acción en el mundo entre trabajadores y trabajadoras, los procesos de colectivización y/o individualización que se producirán, así como el estado de las formas de vida que se crearán. También analiza qué puede hacer la Clínica del Trabajo en la pandemia, así como cuáles son las modulaciones necesarias en el campo clínico del trabajo en vista de las nuevas urgencias de nuestro tiempo, entre las cuales destacamos la importancia de seguir la normatividad experimentada en el y para el trabajo como actividad, en este momento de intensas transformaciones en los procesos laborales debido a la crisis de salud de Covid-19.

Environmental non-governmental organizations and global environmental discourse.

Environmental non-governmental organizations (ENGOs) exist worldwide, and since the 1980s they have increasingly influenced global environmental politics and environmental discourse. We analyze an original dataset of 679 ENGOs participating in global environmental conventions in the mid-2010s, and we apply quantitative content analysis to ENGO mission statements to produce an inductive typology of global environmental discourse. Discourse categories are combined with ENGO attribute data to visualize the political topology of this globally-networked ENGO sector. Our results confirm some common assertions and provide new insights. ENGOs are more diverse than conventionally recognized. Quantitative evidence confirms strong North-South disparities in human and financial resources. Four primary discourses are identified: Environmental Management, Climate Politics, Environmental Justice, and Ecological Modernization. We compare our typology to existing literature, where Climate Politics and Environmental Justice are under-appreciated, and we discuss ways to expand on the data and methods of this study. Synoptic empirical ENGO research is essential to accurately understanding the ENGO sector and global environmental politics.

Today's Leadership Lesson: Mind the Wildlife and Prepare for Tomorrow's Disruption.

As the world reacts with unprecedented efforts to contain the COVID-19 pandemic, the role of organizational leaders is to embark on a parallel track to keep mission-critical initiatives moving forward. One track includes preparing their organizations for the next "novel" virus. After all, organizations do not hire leaders to maintain the status quo; they are hired to drive the future. As much as death and taxes are inevitable, it is equally predictable that all organizations will sooner or later confront a black swan event. History teaches us that while the order of magnitude may vary, management crises are not entirely novel. This article explores a series of early risk mitigation strategies to prevent the next COVID-19 and prepare leadership to face this inevitable challenge.

Team Rubicon Medical Response to Hurricane Dorian in the Bahamas.

On September 1, 2019, Hurricane Dorian made landfall as a category 5 hurricane on Great Abaco Island, Bahamas. Hurricane Dorian matched the "Labor Day" hurricane of 1935 as the strongest recorded Atlantic hurricane to make landfall with maximum sustained winds of 185 miles/h.1 At the request of the Government of the Bahamas, Team Rubicon activated a World Health Organization Type 1 Mobile Emergency Medical Team and responded to Great Abaco Island. The team provided medical care and reconnaissance of medical clinics on the island and surrounding cays….

Outcome evaluation of a "common factors" approach to develop culturally tailored HIV prevention interventions for people who inject drugs.

BACKGROUND: Current models of HIV prevention intervention dissemination involve packaging interventions developed in one context and training providers to implement that specific intervention with fidelity. Providers rarely implement these programs with fidelity due to perceived incompatibility, resource constraints, and preference for locally-generated solutions. Moreover, such interventions may not reflect local drug markets and drug use practices that contribute to HIV risk. PURPOSE: This paper examines whether provider-developed interventions based on common factors of effective, evidence-based behavioral interventions led to reduction in drug-related HIV risk behaviors at four study sites in Ukraine. METHODS: We trained staff from eight nongovernmental organizations (NGOs) to develop HIV prevention interventions based on a common factors approach. We then selected four NGOs to participate in an outcome evaluation. Each NGO conducted its intervention for at least N = 130 participants, with baseline and 3-month follow-up assessments. RESULTS: At three sites, we observed reductions in the prevalence of both any risk in drug acquisition and any risk in drug injection. At the fourth site, prevalence of any risk in drug injection decreased substantially, but the prevalence of any risk in drug acquisition essentially stayed unchanged. CONCLUSIONS: The common factors approach has some evidence of efficacy in implementation, but further research is needed to assess its effectiveness in reducing HIV risk behaviors and transmission. Behavioral interventions to reduce HIV risk developed using the common factors approach could become an important part of the HIV response in low resource settings where capacity building remains a high priority.

Identificación de patrones de comportamiento informativo en los textos mediante el Análisis de Redes Sociales / Identification of patterns of informative behavior in the texts with the Social Networks Analysis

Resumen Se presentan los resultados de una investigación, cuyo objetivo es identificar patrones de conocimiento significativo en el contenido de la documentación presentada para la evaluación del Ambiente Organizacional de 13 empresas mexicanas, que integran el ranking de Súper Empresas ® elaborado por la Consultora Top Companies ® . Por medio del procesamiento cuantitativo de seis variables, seis indicadores y el Análisis de Redes Sociales, se visualizan mapas de relaciones entre las empresas y los atributos de las variables seleccionadas. Con el uso de la fuente y la metodología empleadas se revelan patrones de comportamiento informativo presentes en la documentación objeto de estudio que aportan nuevo conocimiento para la toma de decisiones sobre la evaluación y la elaboración de los rankings empresariales que generan las consultoras especializadas sobre la referida temática.

Abstract This paper reports the results of research aimed at identifying patterns of significant knowledge contained in the documentation of thirteen Mexican companies submitted for the purpose of the Organizational Environment evaluation of "Super Companies", a ranking issued exclusively by the consulting firm Top Companies®. Maps of company relationships and the attributes of the selected variables are developed on the basis of the quantitative processing of six variables and indicators, and an analysis of social networks. The sources and the methodology employed reveal patterns of informational behavior in the specialized documentation that can serve to support decision making with regard to the evaluation and preparation of the rankings issued by the specialized consultants.

Does involvement of local NGOs enhance public service delivery? Cautionary evidence from a malaria-prevention program in India.

Partnerships between government and non-state actors that aim to enhance the quality or efficiency of service delivery are increasingly common in today's development policy landscape. We investigate the impacts of such an approach using data from an experimental supportive intervention to India's malaria control program that leveraged local non-state capacity in order to promote mosquito net usage and recommended fever care-seeking patterns. The supportive activities were conducted simultaneously by 3 NGOs, contracted out by the Indian government, in 2 endemic districts in the state of Odisha. We find that program impact significantly varied by location. Examining 3 potential sources of this variation (differential population characteristics, differential health worker characteristics, and differential implementer characteristics), we provide evidence that both population and NGO characteristics significantly affected the success of the program. Specifically, the results suggest that the quality and effort of the local implementer played a key role in the differential effectiveness. We discuss these findings as they relate to the external validity of development policy evaluations and, specifically, for the ability of health and other service delivery systems to benefit from limited non-state capacity in underresourced areas.

[German ophthalmology in developing countries : Partnerships with eye clinics in developing countries - an initiative of the German Ophthalmological Society]. / Deutsche Augenheilkunde in Entwicklungsländern : Partnerschaften mit Augenkliniken in Entwicklungsländern ­ eine Initiative der Deutschen Ophthalmologischen Gesellschaft.

In 1999 the global initiative "Vision 2020 - The Right to Sight" was established by the World Health Organization (WHO), the International Agency for the Prevention of Blindness (IAPB) and several non-governmental organizations (NGOs) with the goal of reducing avoidable blindness. Based on this initiative, the working group "International Ophthalmology" of the German Ophthalmological Society (DOG), which was established in 1994, was converted into a DOG section with the same name in 2004 and represents one of the core components of the DOG; however, even before there were a number of established partnerships of German and African eye hospitals. The first cooperation of this kind was the partnership between the Department of Ophthalmology, Ludwig-Maximilians University Munich and the University of Nairobi, Kenya, which was founded in 1978. As a result of this cooperation, the Department of Ophthalmology in Nairobi has evolved into one of the major centers of ophthalmological training and ophthalmic care in East Africa. Since then a number of similar cooperation projects between several hospitals and numerous further projects (e. g. in Myanmar) have been implemented and some of these are presented in this manuscript.

Safe Sex in the 1970s: Community Practitioners on the Eve of AIDS.

In the 1970s, groups of gay and gay-allied health professionals began to formulate guidelines for safer sexual activity, several years before HIV/AIDS. Through such organizations as the National Coalition of Gay Sexually Transmitted Disease Services, Bay Area Physicians for Human Rights, and the Sisters of Perpetual Indulgence, these practitioners developed materials that would define sexual health education for the next four decades, as well as such concepts as "bodily fluids" and the "safe sex hanky." To do so, they used their dual membership in the community and the health professions. Although the dichotomy between the gay community and the medical establishment helped define the early history of HIV/AIDS, the creative work of these socially "amphibious" activists played an equally important part. Amid current debates over preexposure prophylaxis against HIV and Zika virus transmission, lessons for sexual health include the importance of messaging, the difficulty of behavioral change, and the vitality of community-driven strategies to mitigate risk.

[Experience and present situation of Western China Gastric Cancer Collaboration].

The Western China Gastric Cancer Collaboration (WCGCC) was founded in Chongqing, China in 2011. At the early stage of the collaboration, there were only about 20 centers. While now, there are 36 centers from western area of China, including Sichuan, Chongqing, Yunnan, Shanxi, Guizhou, Gansu, Qinghai, Xinjiang, Ningxia and Tibet. During the past few years, the WCGCC organized routinely gastric cancer standardized treatment tours, training courses of mini-invasive surgical treatment of gastric cancer and the clinical research methodology for members of the collaboration. Meanwhile, the WCGCC built a multicenter database of gastric cancer since 2011 and the entering and management refer to national gastric cancer registration entering system of Japan Gastric Cancer Association. During the entering and collection of data, 190 items of data have unified definition and entering standard from Japan Gastric Cancer Guidelines. Nowadays, this database included about 11 872 gastric cancer cases, and in this paper we will introduce the initial results of these cases. Next, the collaboration will conduct some retrospective studies based on this database to analyze the clinicopathological characteristics of patients in the western area of China. Besides, the WCGCC performed a prospective study, also. The first randomized clinical trial of the collaboration aims to compare the postoperative quality of life between different reconstruction methods for total gastrectomy(WCGCC-1202, ClinicalTrials.gov Identifier: NCT02110628), which began in 2015, and now this study is in the recruitment period. In the next steps, we will improve the quality of the database, optimize the management processes. Meanwhile, we will engage in more exchanges and cooperation with the Chinese Cochrane Center, reinforce the foundation of the clinical trials research methodology. In aspect of standardized surgical treatment of gastric cancer, we will further strengthen communication with other international centers in order to improve both the treatment and research levels of gastric cancer in Western China.

Global health partnerships: building multi-national collaborations to achieve lasting improvements in maternal and neonatal health.

BACKGROUND: In response to health care challenges worldwide, extensive funding has been channeled to the world's most vulnerable health systems. Funding alone is not sufficient to address the complex issues and challenges plaguing these health systems. To see lasting improvement in maternal and infant health outcomes in the developing world, a global commitment to the sharing of knowledge and resources through international partnerships is critical. But partnerships that merely introduce western medical techniques and protocols to low resource settings, without heeding the local contexts, are misguided and unsustainable. Forming partnerships with mutual respect, shared vision, and collaborative effort is needed to ensure that all parties, irrespective of whether they belong to resource rich or resource poor settings, learn from each other so that meaningful and sustained system strengthening can take place. METHODS: In this paper, we describe the partnership building model of an international NGO, Kybele, which is committed to achieving childbirth safety through sustained partnerships in low resource settings. The Kybele model adapts generic stages of successful partnerships documented in the literature to four principles relevant to Kybele's work. A multiple-case study approach is used to demonstrate how the model is applied in different country settings. RESULTS: The four principle of Kybele's partnership model are robust drivers of successful partnerships in diverse country settings. CONCLUSIONS: Much has been written about the need for multi-country partnerships to achieve sustainable outcomes in global health, but few papers in the literature describe how this has been achieved in practice. A strong champion, support and engagement of stakeholders, co-creation of solutions with partners, and involvement of partners in the delivery of solutions are all requirements for successful and sustained partnerships.

Characterizing Hospital Admissions to a Tertiary Care Hospital After Typhoon Haiyan.

OBJECTIVE: On November 8, 2013, Typhoon Haiyan (Yolanda) made landfall in the Philippines. The literature characterizing the medical, surgical, and obstetrics burden following typhoons is lacking. This study aimed to improve disaster preparedness by analyzing medical diagnoses presenting to a city district hospital before, during, and after Typhoon Haiyan. METHODS: The assessment of disease burden and trends was based on logbooks from a local hospital and a nongovernmental organization field hospital for the medicine, surgical, and obstetrics wards before, during, and after the typhoon. RESULTS: The hospital provided no services several days after typhoon impact, but there was an overall increase in patient admissions once the hospital reopened. An increase in gastroenteritis, pneumonia, tuberculosis, and motor vehicle collision-related injuries was seen during the impact phase. A dengue fever outbreak occurred during the post-impact phase. There was a noticeable shift in a greater percentage of emergent surgical cases performed versus elective cases during the impact and post-impact phases. CONCLUSION: Overall, several public health measures can prevent the increase in illnesses seen after a disaster. To prepare for the nonfatal burden of disease after a typhoon, health care facilities should increase their resources to accommodate the surge in patient volume.